Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.
Section 843.282 - Submitting Complaints to Department(a) Any person, including a person who has attempted to resolve a complaint through a health maintenance organization's complaint system process and is dissatisfied with the resolution, may submit a complaint to the department alleging a violation of:(3) Subchapter A, Chapter 1452;(4) Subchapter B, Chapter 1507;(5) Chapters 222, 251, and 258, as applicable to a health maintenance organization; or(6) Chapter 1271 or 1272.(b) The commissioner shall complete an investigation of a complaint against a health maintenance organization to determine whether a violation has occurred not later than the 60th day after the date the department receives the complaint and all information necessary for the commissioner to make a determination.(c) The commissioner may extend the time necessary to complete an investigation if:(1) additional information is needed;(2) an on-site review is necessary;(3) the health maintenance organization, the physician or provider, or the complainant does not provide all documentation necessary to complete the investigation; or(4) other circumstances beyond the control of the department occur.Amended By Acts 2007, 80th Leg., R.S., Ch. 730, Sec. 2E.047, eff. 4/1/2009.Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. 6/1/2003.